| Renew Life Rejuvenation Of The Woodlands, Pllc | |
|
3000 Research Forest Dr Ste 150 Spring TX 77381-4395 | |
| (281) 651-2020 | |
| (281) 292-6388 |
| Full Name | Renew Life Rejuvenation Of The Woodlands, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3000 Research Forest Dr Ste 150, Spring, Texas |
| Authorized Official Name and Position | Christopher Zaino (PARTNER) |
| Authorized Official Contact | 2817955231 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Life Rejuvenation Of The Woodlands, Pllc 3000 Research Forest Dr Ste 150 Spring TX 77381-4395 Ph: (281) 651-2020 | Renew Life Rejuvenation Of The Woodlands, Pllc 3000 Research Forest Dr Ste 150 Spring TX 77381-4395 Ph: (281) 651-2020 |
| NPI Number | 1700407186 |
|---|---|
| Provider Enumeration Date | 04/27/2020 |
| Last Update Date | 04/27/2020 |
| Medicare PECOS PAC ID | 9739519067 |
|---|---|
| Medicare Enrollment ID | O20200428001074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700407186 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Ronald Alan Buczek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962448811 PECOS PAC ID: 6608764212 Enrollment ID: I20121031000597 |
| Provider Name | Rosemary Jacqueline Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629283239 PECOS PAC ID: 1052563616 Enrollment ID: I20121205000051 |
| Provider Name | Vi Y Chau-tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861873655 PECOS PAC ID: 0840505178 Enrollment ID: I20150817000893 |
| Provider Name | Brian M Karst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710483490 PECOS PAC ID: 1052675519 Enrollment ID: I20180509000592 |
| Provider Name | Mina L Ledoux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821555335 PECOS PAC ID: 2961742960 Enrollment ID: I20190328000987 |
| Provider Name | Katherine R Watt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619458387 PECOS PAC ID: 4183056310 Enrollment ID: I20191108002351 |
| Provider Name | Bernadette Olivier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457345308 PECOS PAC ID: 1658320163 Enrollment ID: I20200205000133 |
| Provider Name | Claire Slaughter White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083156327 PECOS PAC ID: 6507119930 Enrollment ID: I20210122002179 |
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